Introduction to Speech and Language Therapy

Speech and Language Therapy

Speech and language therapy is concerned with the identification, assessment and support of speech, language, communication and swallowing needs of children, young people and adults. Speech and language therapy is the process of enabling people to communicate to the best of their ability.

Speech and Language Therapists (SLT)

Speech–language therapists/pathologists are professionals educated in the study of human communication, how it develops and the many differences and difficulties that children and adults experience. Speech and language therapists assess the nature of the client’s problem, and then provide treatment, advice and support. They also work closely with families, carers and members of other professions including doctors, physiotherapists and teachers.

Some speech and language therapists also work with people who have eating and swallowing difficulties, as well as communication problems. Communication difficulties refer to challenges with speaking, understanding and/or using language, listening, social skills, stuttering, reading, writing and using voice. Speech pathologists also help people who have difficulties eating and drinking safely. Most speech and language therapists work in NHS hospitals or clinics but some work in independent practice, in research and education, or in schools.

People Who Benefit from Speech and Language Therapy

Speech and language therapy benefits people of all ages, for example:

• Infants: SLTs support premature babies and infants with conditions such as cerebral palsy, cleft palate and Down syndrome from very early in life who have difficulties with drinking, swallowing and early play and communication skills.
• Children: SLTs support children with primary speech, language and communication difficulties, such as stammering, as well as speech, language and communication difficulties that are secondary to other conditions such as learning difficulties and hearing problems.
• Adults with learning difficulties: SLTs support adults who have developmental conditions such as learning disabilities, autism and Down syndrome.
• Adults: SLTs support adults with communication and/or swallowing difficulties as a result of medical conditions, such as stroke, head and neck cancer, Parkinson’s disease and dementia.

Where Speech and Language Therapist Work:

Speech and language therapists work together with children, adults, families, carers and the wider workforce, to carry out assessments and plan personalised therapy programmes which meet each individual’s communication and swallowing needs.

They work in wide variety of contexts and environments including:

• community health centres
• hospital wards and intensive care units
• outpatient departments
• children’s centres, mainstream and special schools
• assessment units, day centres and nursing homes
• clients’ homes
• courtrooms, prisons and young offenders’ institutions

There are approximately 12,500 practising SLTs in the UK. The National Health Service employs the majority of SLTs; however, increasing numbers work wholly or partly in education or for charities, while a number work independently and treat patients privately (as well as other areas).

How can a speech pathologist help?

Speech pathologists can support people in the following areas:

• Speech delays and disorders – articulation and producing speech sounds
• Expressive language – using language to share thoughts, feelings and ideas
• Receptive language – understanding language, word meanings and instructions
• Augmentative and alternative communication for people with difficulties speaking and writing e.g. using pictures, communication boards or assistive devices to support understanding and expression of language
• Fluency – supporting people who stutter to speak more fluently and with confidence
• Feeding and swallowing difficulties – supporting infants, children and adults who have difficulties eating, drinking and swallowing safely
• Pre literacy and literacy skills – learning to read, write and spell
• Voice – disorders of the voice including pitch, quality, volume
• Social  communication difficulties – communicating for social purposes and following the rules for conversation
• Cognitive-communication disorders – organising thoughts, planning, reasoning, paying attention, remembering and problem solving
• Aural rehabilitation for people who are deaf or hard of hearing
• Accent modification

Communication Problems in School

A child may have gotten help for speech or language problems before he started school. Problems may be noticed when he starts school. A child may have trouble with:

• Speech sounds. He may have trouble saying sounds. He may not speak clearly and be hard to understand.
• Language and literacy. A child may have trouble understanding what she hears. She may not follow directions or answer questions well. It may be hard for her to tell others about her thoughts. She may not say the correct words or say only short sentences. Language problems can also make reading and writing harder.
• Social communication. A child may have trouble talking with other children. He may not make friends easily. He may not understand what others think or how they feel.
• Cognitive communication. These are the thinking skills a child needs to remember, solve problems, and use her imagination. Learning disabilities and brain damage can cause these types of problems.
• Feeding and swallowing. It may sound strange to think of eating as a school problem, but it can be. Feeding and swallowing problems can make it hard for a child to eat and drink enough during the day. This can make it hard to learn. It can also make social times, like lunch or snack, harder for a child.
• Stuttering. A child may have trouble speaking smoothly. She may repeat sounds or words or have long pauses when she talks. Stuttering can make it hard to answer questions or give speeches in class. It can also make it hard to talk to friends.
• Voice. A child may sound hoarse or lose his voice. He may sound like he talks through his nose, called nasality. His voice may be too loud or too soft. Voice problems can make it hard to talk in class or with friends.

A child may have speech or language problems. He may not be able to do grade-level work. He may have trouble reading, writing, and spelling. He may not understand social cues, like what a person means when he nods or looks away as you speak. He may have trouble taking tests and may not want to go to school.

The school SLT sees the child. A child may get referred to a child study team for testing. The SLT may be a part of this team, along with teachers, special education teachers, a psychologist, or others. The SLT will test the child’s speech and language skills and decide if the child needs treatment.

A child may get speech and language services alone or in a small group. The SLT may go into a child’s classroom and work with his teacher. The SLT will work with the child on what she is learning in class. The goal of speech and language services is to help the child do well in school. The SLT will work as part of a team that makes sure that the child gets the services she needs.

Responsibilities of a Speech Therapist

Speech therapists are members of the allied healthcare team. They work closely with doctors, nurses, and other therapists to diagnose problems and develop a treatment plan.

Speech therapists may perform various tests to determine the person’s deficits or language limitations. For example, they may perform swallow evaluations on a stroke or brain injured patient to make sure they won’t choke on food or liquids. Therapists may also administer various standardized tests to identify neurological problems, which may be interfering with speech or language.

After they have made a diagnosis, speech therapists develop an appropriate treatment plan. Treatment may include teaching patients exercises to strengthen swallowing muscles and helping patients improve sounds and pronunciation of letters and words. In some instances, speech therapists teach patients how to use alternative methods of communication, such as sign language.